Stop Shackling Pregnant Detainees: New Bill Mandates Release and Comprehensive Healthcare in Immigration Custody

This bill, officially titled the Stop Shackling and Detaining Pregnant Women Act, fundamentally changes how the Department of Homeland Security (DHS) handles noncitizens who are pregnant, breastfeeding, or recently postpartum. It immediately requires access to pregnancy testing upon intake and establishes a strong presumption against detaining these individuals. If someone is found to be pregnant while detained, they must be released within 24 hours, unless the government can prove exceptional circumstances—specifically, that the person poses an immediate, serious physical danger to others or is an unmanageable flight risk (SEC. 3).

The End of Restraints and the 5-Day Rule

For most people, the most impactful change is the near-total ban on using physical restraints—like handcuffs, leg irons, and belly chains—on anyone known to be pregnant, in labor, delivering, or postpartum, even during transport (SEC. 4). The bill explicitly bans severe restraints like leg, waist, or 4-point restraints completely. If restraints are used under the rare exception (only if there’s an immediate risk of harm or escape), they must be the least restrictive possible, and a doctor or nurse can order their removal instantly. Crucially, no one in labor or delivery can ever be restrained. For those few individuals who remain detained because they pose an immediate threat, their case must be reviewed individually every single week to see if they still meet the high bar for detention (SEC. 3).

Comprehensive Care, From Prenatal to Postpartum

This legislation isn’t just about custody; it’s about health. It requires DHS facilities to provide comprehensive medical care, including regular and specialized prenatal care, treatment for complications, and mental health services (SEC. 4). This care must also include access to post-delivery care, reversible birth control options, lactation services, and even access to abortion services, all provided only with the detainee’s informed consent. For the DHS agencies and facility administrators, this means a massive overhaul of medical protocols and staffing to align with national standards for maternal health—a significant administrative lift, especially for smaller facilities.

Accountability and Transparency: Who’s Watching?

To ensure this isn't just paper policy, the bill builds in serious accountability. Facility administrators must now report quarterly to the Secretary of Homeland Security. These reports must detail the total number of pregnant noncitizens held, their average length of stay, and, most critically, every single incident where restraints were used, including the justification (SEC. 6). They even have to report on pregnancy outcomes, including live births, stillbirths, miscarriages, and maternal health issues. While these reports will be made publicly available online, the bill makes a specific carve-out: the name of the facility administrator who authorized the restraint cannot be made public, which could make it harder to pin down accountability for specific decisions.

The Fine Print: Where the Gray Areas Lie

While the intent is clearly protective, the bill’s reliance on the term “extraordinary circumstances” to justify continued detention or restraint use introduces a medium level of vagueness (SEC. 3, SEC. 4). This phrase grants facility administrators significant discretionary power. If the administrators interpret “immediate risk of escape” too broadly, it could undermine the presumption of release, especially during necessary transport. However, the requirement for mandatory staff training (SEC. 5), weekly review, and public reporting on restraint use acts as a strong check against potential overreach, forcing administrators to document and justify every single exception they make.